Acute group A streptococcal infections and sequelae (pediatrics) Quiz: Ace Your Exams
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A 10-year-old girl is brought to the emergency department by her parents due to fever, vomiting, and confusion that developed over the course of a day. Three days prior, she fell off her bike while going down a hill and suffered multiple abrasions to her left knee that were cleaned and covered at home. The patient has no significant past medical history and is up to date on her vaccinations. Temperature is 39.4°C (103°F), pulse is 132/min, respiratory rate is 22/min, blood pressure is 86/64 mmHg, and oxygen saturation is 97% on room air. The patient responds only to painful stimuli. The skin over the left knee shows signs of swelling and erythema but no necrosis or bullae. A diffuse erythematous, macular rash with desquamation is noted over her trunk and extremities, and shedding is significant over the palms and soles. Laboratory studies are obtained and can be seen below. Blood cultures are collected and pending. Which of the following is the best next step in management?
| Laboratory value | Result |
| Hemoglobin | 12 g/dL |
| Creatinine | 2.0 mg/dL |
| Leukocyte count | 15,000/mm3 |
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